Management of Traumatized Permanent Maxillary Immature Incisor with Oblique Subgingival Crownroot Fracture

Abstract

Background: Trauma to the anterior teeth is a common injury in young children. The
maxillary incisors being the most affected. Although root fractures are rare, they
do occur and were previously and often considered hopeless and were extracted.
The time between the injury and the initiation of treatment, level of the fracture
line, and stage of root development are some criteria to be considered when
choosing a treatment approach for a complicated tooth fracture. This case report
describes the management of a traumatized immature maxillary central incisor
with Elise class IV fracture with vertical oblique subgingival fracture of the root.
Materials and method: Apexification was carried out using biodentine followed by
removal of the fractured segment. A fiber post was cemented in the root canal
with resin cement. The coronal portion of the tooth was restored using anterior
light cured composite material. The tooth was examined and evaluated after 1
week and after 2 months by clinical examination and radiographical evaluation of
root development.
Results: The follow up evaluation revealed clinical and radiographical success.
Radiographic view showed continued development in the apex of the root and
showed normal periodontal ligament space and dense lamina dura.
Conclusion: Extraction should not be the first choice of treatment for extensively
damaged young permanent teeth in the anterior region; instead, alternative
treatment modalities must be considered. The traumatized immature tooth was
saved and restored.